Fluvoxamine may ease fatigue in adults with long COVID
Mean Fatigue Severity Scale scores were 0.43 points lower than placebo at day 60 and 0.58 points lower at day 90.
Annals of Internal Medicine
In Brazil, 399 adults with fatigue 90 days to 24 months after confirmed COVID-19 infection participated in a randomised, placebo-controlled trial. Participants took fluvoxamine, metformin or a matching placebo for 60 days, with follow-up to day 90. The fluvoxamine dose was 100 milligrams twice daily.
Researchers measured changes using the Fatigue Severity Scale, a measure of fatigue severity. Fluvoxamine reduced average fatigue scores compared with placebo at days 60 and 90. It also improved quality-of-life scores. Metformin findings were inconclusive. Adverse events occurred in 24.0% of participants assigned fluvoxamine, compared with 35.5% assigned placebo. No deaths were related to treatment. The researchers concluded that fluvoxamine showed potential for improving long COVID fatigue and quality of life.
Why it matters
Long COVID fatigue is debilitating, so testing symptom relief addresses quality of life—an aspect of healthy lifespan.
Caveats
Follow-up ended at day 90, leaving longer-term benefits unknown; the trial did not address other long COVID symptoms. Metformin findings were inconclusive after adverse effects prompted a dose change and its study group stopped early.
The paper
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Lehana Thabane, Thiago Santiago Ferreira, Luiza Lanna França Reis, Ana Paula Figueiredo Guimaraes Almeida, Marcela Menezes Amaral, Leonardo Cançado Monteiro Savassi, Vitoria Helena de Souza Campos, Maria Izabel Campos Simplicio, Luciene Barra Ribeiro, Thalyne de Souza Medeiros, Thais Campos Siqueira, Taynara Silva Vieira, Nayara Drumond Rausse, Tereza Cristina Garofolo, Eliane Carreiro Fagundes Silva, Ofir Harari, Gennaro D'Urso, Jamie I Forrest, Jay Park, Jean B Nachega, Christopher Lindsell, Jeffrey S Glenn, Kristian Thorlund, Mark Dybul, Edward J Mills,McMaster University
Annals of Internal Medicine · 6 Oct 2026